Re: Low carbohydrate regimens (was Atkins' diet testimonial)
Sun, 28 Nov 1999 13:00:45 EST

In a message dated 11/28/99 3:02:05 AM Pacific Standard Time, writes:

>> The situation resembles that of somebody with advanced diabetes,
>> although this kind of ketosis won't kill you directly.
> The condition which damages diabetics is called ketoacidosis; it is not
> the same as ketosis. The underlying metabolic defects in a diabetic
> system lead to a metabolic derangment characterised by loss of pH
> control in the body; any system not plagued by these defects can adapt
> to ongoing ketosis.

The cause of the metabolic pH derangement *is* the production of ketone bodies (i.e. ketosis) which are acidic. Too much acid exhausts the ability of the kidney to maintain acid-base balance and down you go. (Stryer's Biochemistry, 3rd edition, p 641-642)
It's not a problem with starvation ketosis because the body doesn't make that many ketone bodies. I suppose it could be a problem with Atkins-style ketosis (more food = more ketones) but I've never heard of it; given the medical
community's take on Atkins that makes me think it's not a problem.

> Quote resumes:
> You can lose weight like crazy on this plan. You will also be physically
> weak, often nauseous, and you will smell like nail polish remover.
> *****************************************
> These problems tend to result from dehydration & electrolyte imbalance,
> which can also be induced by exercise; in both cases, rehydration &
> supplementation are fairly simple.

Part of this is from dehydration and electrolyte imbalance, directly caused by the ketosis and presumably treatable. But part is from low blood sugar, which weakens glycolytic muscle and the brain, and part from the weird chemicals that come out of the process like acetone, plus whatever the sulfur ends up as.

>> If you go on the diet and then off it, you will gain back all you lost.

>This is one of the most frequently levelled charges against this type of
>diet. It happens to be correct, but the same is true of *any* reducing

True as far as I know. Controlled comparisons of ketotic diets with nonketotic diets showed they were similar in both amount lost and regained. Reduced hunger was contentious; studies differed, as I recall.

>> If you stay on it, you'll subject your body indefinitely to a metabolic
>>regime it's manifestly not adapted for.

>Ketosis is only to be maintained until the goal weight is reached. At
>that point, carbohydrates are gradually reintroduced into the diet until
>ketosis ends & weight loss stops.

Dr. Atkins may have changed his recommendations. He was originally recommending lifetime borderline ketosis. As a short-term weight loss method, the Atkins diet doesn't worry me much. As I understand, though, Atkins still recommends very-low-carb lifetime diets and that could cause trouble with vitamin deficiency or with all those sulfur-containing amino acids.

>As to atkins-as-quack, this holds a certain amount of truth as well.
>While I believe he got the low-carbohydrate thing mostly right (as well
>as the utility of antioxidants & other nutrients), he advocates some
>practices (ex: chelation therapy) that have been pretty thoroughly

When I refer to Atkins as a "quack" I don't say he's necessarily wrong, but that he hasn't performed ethically or scientifically adequate tests. He may actually be right, but if so it's by dumb cluck luck.

>Still, the low-carb meme does have some almost cultish adherents; on
>the usenet group, people on different low carb
>diets argue strenuously over whose is the One True Way. I try to think
>of it as a chance to see memetic evolution in action.

Part of my frustration with Atkins is that I think low-carb diets truly deserve
investigation. They're probably useful for short-term weight loss; some good scientific work would delimit the use of it and perhaps even find ways around the disadvantages.